熱門新聞
加利福尼亞推進和創新媒體卡(CalAIM)更新
強制性管理護理註冊
強制性託管護理註冊將標準化註冊流程,以幫助確保在各縣之間移動的人口受到相同的要求,從而消除根據援助守則、人口和地理位置的福利的差異。 強制性管理護理註冊有兩個階段:
- 對於第一階段,DHCS 於 10 月將第一份受益人通知和常見問題(FAQ)文件郵寄給受影響受益人,有關他們過渡到託管護理或服務費(FFS)遞送系統(FFS)的系統,從 1 月 2022 生效。
- 關於第二階段,DHCS 於十一月發送了有關轉換的第二個受益人通知和常見問題解答。 DHCS 還在 11 月底發送 Medi-Cal 託管護理選擇包給符合受管理護理計劃(MCP)註冊的受益人。
管理護理福利標準化
受管理的護理福利標準化將有助於確保管理照護和 FFS 在全州提供的福利的一致性,從而減少複雜性和縣對縣的差異。 在福利標準化下,主要器官移植(目前僅在縣組織健康系統(COHS)縣內的受保福利)將為所有註冊 MCP 的 Medi-Cal 成員納入全州的 Medi-Cal MCP,從 2022 年 1 月 1 生效。 此外,多用途高級服務計劃(MSSP)將分配給 FFS,並在所有協調照護倡議(CCI)示範縣作為 1915(c)MSSP 豁免福利,從 1 月 2022 生效。 11 月,CCI 各縣的 MCP 向受影響的受益人郵寄了收款人通知和附加信息通知文件,有關拆除 MSSP 服務。
牙科計劃
On September 28, DHCS submitted State Plan Amendment (SPA) 21-0019 to the Centers for Medicare & Medicaid Services (CMS) for federal approval of CalAIM dental initiatives. The SPA is under review; the public comment period ended on September 6. The FFS and safety net clinic (SNC) provider bulletins are published on the Medi-Cal and Medi-Cal Dental websites. Please visit the DHCS website for more information about each CalAIM dental initiative, including required forms and SNC billing requirements.
中醫新冠肺炎疫苗接種激勵計劃
DHCS is allocating up to $350 million to incentivize COVID-19 vaccination efforts in the Medi-Cal managed care delivery system for the service period of September 1, 2021, through February 28, 2022. Medi-Cal MCPs are eligible to earn incentive payments for activities designed to close vaccination gaps with their enrolled members, and to address vaccine uptake disparities for specific age and race/ethnicity groups. MCPs may earn up to $50 million for achieving specified process measures and $200 million for outcome measures, with $100 million available for MCPs to use for direct member incentives. Effective September 1, 2021, all 25 full-service MCPs and one population-specific health plan were approved for participation in the program, and DHCS will provide payment allocations for the approved vaccination response plans. DHCS provided baseline data (as of August 29, 2021) to the plans for vaccine uptake outcome measures on October 4, and the MCPs submitted baseline data for their process measures on October 30. The first achievement assessment period ended on October 31. Future achievement assessments will occur in January and March 2022. The high-performance pool component of the incentive program is being developed. For more information, please refer to All Plan Letter 21-010.